AIM:To evaluate the safety and efficacy of tenofovir monotherapy in pregnant females resistant to lamivudine or telbivudine.The effect of tenofovir on the fetus was also assessed.METHODS:The clinical data of 17 female...AIM:To evaluate the safety and efficacy of tenofovir monotherapy in pregnant females resistant to lamivudine or telbivudine.The effect of tenofovir on the fetus was also assessed.METHODS:The clinical data of 17 females were reviewed in this study.Adverse events and pregnancy outcomes from January 1,2011 to June 30,2013 were evaluated in the Department of Gynecology and Obstetrics of BeijingDitan Hospital,Capital Medical University,Beijing,China.These pregnant females developed lamivudine(LAM)-or telbivudine(Ld T)-resistant chronic hepatitis B and received tenofovir(TDF)therapy(300 mg/d),and its curative effect,maternal and perinatal adverse events,fetal growth and development,and neonatal prognosis were evaluated.RESULTS:The median hepatitis B virus(HBV)DNA level in the pregnant females with LAM or Ld T resistance was 5.9(range,4.2-7.2)log10 copies/m L before the initiation of TDF.Ten of these females had abnormal alanine aminotransferase(ALT)levels.The patients were treated with TDF for a median of 24 wk(range,12-40 wk).Fourteen females(82.4%)had an HBV DNA level of<500 copies/m L at the time of delivery.This decrease was statistically significant(P<0.0001).Serum ALT levels were normalized in all subjects with an elevated serum ALT level at baseline(P=0.0003).There were no significant changes in serum creatinine and phosphorus levels during TDF treatment.In addition,no adverse events related to TDF treatment were observed.Seventeen females delivered 17 live infants,and all infants had good Apgar scores.The mean birth weight was 3226.5±331.7 g,and the mean length at birth was 50.4±1.1 cm.The growth and development of the infants was normal at birth,and no infants had birth defects related to TDF treatment.Eleven infants completed HBV vaccination and had no evidence of vertical transmission.CONCLUSION:The use of TDF in pregnant females with chronic HBV and LAM or Ld T resistance was safe and effective.展开更多
AIM:To develop a fuzzy classification method to score the texture features of pancreatic cancer in endoscopic ultrasonography(EUS)images and evaluate its utility in making prognosis judgments for patients with unresec...AIM:To develop a fuzzy classification method to score the texture features of pancreatic cancer in endoscopic ultrasonography(EUS)images and evaluate its utility in making prognosis judgments for patients with unresectable pancreatic cancer treated by EUS-guided interstitial brachytherapy.METHODS:EUS images from our retrospective database were analyzed.The regions of interest were drawn,and texture features were extracted,selected,and scored with a fuzzy classification method using a C++program.Then,patients with unresectable pancreatic cancer were enrolled to receive EUS-guided iodine 125 radioactive seed implantation.Their fuzzy classification scores,tumor volumes,and carbohydrate antigen 199(CA199)levels before and after the brachytherapy were recorded.The association between the changes in these parameters and overall survival was analyzed statistically.RESULTS:EUS images of 153 patients with pancreatic cancer and 63 non-cancer patients were analyzed.A total of 25 consecutive patients were enrolled,and they tolerated the brachytherapy well without any complications.There was a correlation between the change in the fuzzy classification score and overall survival(Spearman test,r=0.616,P=0.001),whereas no correlation was found to be significant between the change in tumor volume(P=0.663),CA199 level(P=0.659),and overall survival.There were 15 patients with a decrease in their fuzzy classification score after brachytherapy,whereas the fuzzy classification score increased in another 10 patients.There was a significant difference in overall survival between the two groups(67 d vs 151 d,P=0.001),but not in the change of tumor volume and CA199 level.CONCLUSION:Using the fuzzy classification method to analyze EUS images of pancreatic cancer is feasible,and the method can be used to make prognosis judgments for patients with unresectable pancreatic cancer treated by interstitial brachytherapy.展开更多
基金Supported by Grants from Beijing Municipal Natural Science Foundation,No.D12110700390000
文摘AIM:To evaluate the safety and efficacy of tenofovir monotherapy in pregnant females resistant to lamivudine or telbivudine.The effect of tenofovir on the fetus was also assessed.METHODS:The clinical data of 17 females were reviewed in this study.Adverse events and pregnancy outcomes from January 1,2011 to June 30,2013 were evaluated in the Department of Gynecology and Obstetrics of BeijingDitan Hospital,Capital Medical University,Beijing,China.These pregnant females developed lamivudine(LAM)-or telbivudine(Ld T)-resistant chronic hepatitis B and received tenofovir(TDF)therapy(300 mg/d),and its curative effect,maternal and perinatal adverse events,fetal growth and development,and neonatal prognosis were evaluated.RESULTS:The median hepatitis B virus(HBV)DNA level in the pregnant females with LAM or Ld T resistance was 5.9(range,4.2-7.2)log10 copies/m L before the initiation of TDF.Ten of these females had abnormal alanine aminotransferase(ALT)levels.The patients were treated with TDF for a median of 24 wk(range,12-40 wk).Fourteen females(82.4%)had an HBV DNA level of<500 copies/m L at the time of delivery.This decrease was statistically significant(P<0.0001).Serum ALT levels were normalized in all subjects with an elevated serum ALT level at baseline(P=0.0003).There were no significant changes in serum creatinine and phosphorus levels during TDF treatment.In addition,no adverse events related to TDF treatment were observed.Seventeen females delivered 17 live infants,and all infants had good Apgar scores.The mean birth weight was 3226.5±331.7 g,and the mean length at birth was 50.4±1.1 cm.The growth and development of the infants was normal at birth,and no infants had birth defects related to TDF treatment.Eleven infants completed HBV vaccination and had no evidence of vertical transmission.CONCLUSION:The use of TDF in pregnant females with chronic HBV and LAM or Ld T resistance was safe and effective.
基金Supported by The National Natural Science Foundation of China,No.30801362 and 81001074
文摘AIM:To develop a fuzzy classification method to score the texture features of pancreatic cancer in endoscopic ultrasonography(EUS)images and evaluate its utility in making prognosis judgments for patients with unresectable pancreatic cancer treated by EUS-guided interstitial brachytherapy.METHODS:EUS images from our retrospective database were analyzed.The regions of interest were drawn,and texture features were extracted,selected,and scored with a fuzzy classification method using a C++program.Then,patients with unresectable pancreatic cancer were enrolled to receive EUS-guided iodine 125 radioactive seed implantation.Their fuzzy classification scores,tumor volumes,and carbohydrate antigen 199(CA199)levels before and after the brachytherapy were recorded.The association between the changes in these parameters and overall survival was analyzed statistically.RESULTS:EUS images of 153 patients with pancreatic cancer and 63 non-cancer patients were analyzed.A total of 25 consecutive patients were enrolled,and they tolerated the brachytherapy well without any complications.There was a correlation between the change in the fuzzy classification score and overall survival(Spearman test,r=0.616,P=0.001),whereas no correlation was found to be significant between the change in tumor volume(P=0.663),CA199 level(P=0.659),and overall survival.There were 15 patients with a decrease in their fuzzy classification score after brachytherapy,whereas the fuzzy classification score increased in another 10 patients.There was a significant difference in overall survival between the two groups(67 d vs 151 d,P=0.001),but not in the change of tumor volume and CA199 level.CONCLUSION:Using the fuzzy classification method to analyze EUS images of pancreatic cancer is feasible,and the method can be used to make prognosis judgments for patients with unresectable pancreatic cancer treated by interstitial brachytherapy.
